Job Location: 10920 Wilshire Blvd Los Angeles, CA 90024 Description:***ALL CANDIDATES MUST BE W2 EMPLOYEES OF THE SUBMITTING AGENCY***
Collections Representative – Government Billing
Location: Hybrid. Will train onsite at 10920 Wilshire Blvd Suite 1600, Los Angeles, CA. Once trained, will work remotely
Duration: 17 weeks to cover LOA
**Required experience: medicare Biller with hospital experience***
Position Summary
The Collections Representative – Government Billing is responsible for the accurate and timely billing of inpatient, outpatient, and laboratory claims to government and third-party payers. This role ensures compliance with payer regulations, billing guidelines, and timely filing requirements while maintaining account accuracy and maximizing reimbursement.
Minimum Qualifications
- High school diploma or equivalent required.
- 2-5 years of experience in Medicare Billing and collection for inpatient and outpatient
- Proficiency with standard office equipment and computer applications.
Key Responsibilities
Claims Billing & Processing
- Review and analyze accounts to determine appropriate billing procedures based on payer type, financial class, and claim requirements.
- Prepare, review, and submit electronic and paper claims in accordance with federal, state, payer, and organizational guidelines.
- Verify claim accuracy, including demographics, charges, authorizations, coding, and supporting documentation.
- Research and obtain missing information from internal departments and external sources as needed.
- Monitor and resolve claim edits, rejections, denials, and billing exceptions.
- Submit required supporting documentation, including authorizations, medical records, consent forms, and payer-specific forms.
- Ensure compliance with timely filing requirements and payer regulations.
- Identify and bill capitated services to the appropriate responsible party.
- Maintain claim management systems and resolve claim scrubber edits and billing holds.
- Account Maintenance & Adjustments
- Process account corrections, adjustments, transfers, rebills, and write-offs according to departmental procedures.
- Update payer, case, and account information accurately and document all actions taken.
- Submit adjustment requests requiring management approval when applicable.
- Maintain accurate account notes and billing documentation within patient accounting systems.
Documentation & ComplianceQuality & PerformanceCustomer Service
- Document billing activity, claim details, expected reimbursement, payments, and account actions clearly and accurately.
- Protect patient confidentiality and comply with HIPAA and organizational privacy standards.
- Adhere to all regulatory requirements, hospital policies, and billing compliance guidelines.
- Maintain established productivity and quality standards.
- Monitor accounts to ensure timely claim submission and follow-up.
- Communicate billing issues, trends, and operational concerns to leadership.
- Participate in performance improvement initiatives and process enhancement efforts.
- Support special projects and departmental objectives as assigned.
- Provide professional and courteous service to patients, payers, and internal stakeholders.
- Demonstrate effective communication and problem-solving skills.
- Foster positive working relationships across departments and with external partners. Required Knowledge & Skills
- Knowledge of hospital billing practices, government payer regulations, and managed care contracts.
- Experience with electronic claims processing and patient accounting systems.
- Proficiency in Microsoft Office applications, including Word and Excel.
- Strong analytical, organizational, and problem-solving skills.
- Ability to manage multiple priorities and meet productivity and quality expectations.
- Knowledge of healthcare billing software and payer portals preferred.
Pay: $22.00 - $25.00 per hour
Work Location: Remote
